1.
The
commonsense assumptions about the costliness of accommodation are not
fully supported by existing empirical research (Acemoglu and Angrist
1998; Blanck 1992; Blanck and Steele 1998; Schartz et al. 2006).
Many people with disabilities can live, work, study, and play alongside
the nondisabled with no specific physical or institutional changes
requiring expensive outlays of dollars or time. Sometimes all
that is necessary is eliminating an arbitrary non-job-related
requirement. For example, a city civil service requirement for a
social worker was that she climb 42 stairs in two minutes –
thereby excluding people who walked more slowly with crutches or
braces. Upon investigation, the New York City Civil Service department
acknowledged that it could not justify the requirement.
Furthermore, empirical research indicates that not only are
accommodations low cost but are actually beneficial and effective
(Schartz et al. 2006; Schreuer et al. 2009; Solovieva et al. 2009).
Furthermore, as Frank Bowe pointed out in 1980, a society that keeps
people with disabilities out of school, work, and neighborhoods is
paying billions of dollars in benefits to keep people dependent.
Bowe sought to demonstrate that it would be less expensive to create an
inclusive society than to keep intact the special benefits and programs
for people with disabilities.

2.
Moreover, proportionality
is not an absolute requirement of justice – in some contexts
(though probably not parking), the opportunity costs of achieving
proportionality might be too great, taking resources that were more
urgently required elsewhere to redress or reduce injustice.

3.
The
appearance of a closer connection between causation and justice may
reflect the use of the same moral baseline for determining both, i.e.,
the view that a disadvantage is caused by a social arrangement if and
only if it would not have existed under a morally-privileged baseline
– e.g., a state of nature or a collectivist utopia. If
causation is assessed by the latter baseline, then any disadvantage
caused by an existing social arrangement will be an injustice. But the
use of such a baseline for determining causation or justice needs to be
justified. (See n. 9, infra.)

4.
For a distinction between
several ways in which social institutions can causally contribute to
the distribution of advantage, and an argument that these distinctions
are morally relevant to the assessment of justice claims, see Pogge
(2004a, 2004b).

5.
The term “stimming” is short for self-stimulatory behavior, sometimes
also called “stereotypic” behavior. In a person with autism, stimming
usually refers to specific behaviors such as flapping, rocking,
spinning, or repetition of words and phrases.

6.
It is not clear that the minority-group model
would, either. Seeing people with disabilities as a “discrete and
insular minority subject to a history of persecution and
exclusion” (ADA –Preamble) does not mean seeing every
disadvantage to that group as resulting from that history. Some
proponents of a minority group model regard anything less than full
inclusion as discriminatory, and dismiss undue burden exceptions as
political concessions (Drimmer 1993). But most proponents of that
model appear to reject this view; most recognize that the costs of
physical and social environmental reconstruction set limits on how much
of it is required (e.g., Amundson 1992, 116). They differ, however, in
whether they see these limits as a matter of distributive justice. To
the extent they do, their policy prescriptions may not differ from
those offered by proponents of the human variation model.

7.
Profound intellectual and
psychiatric impairments may also pose serious challenges for the
medical model, in that many of those impairments may be difficult to
understand as biomedical dysfunction or disease or to treat with
biomedical interventions.

8.
One
case that appears to present a clear contrast involved the installation
of a ramp for a White Mountain hut in New Hampshire. The hut was
accessible only by trails that appeared too rough and steep for
wheelchair users. Proponents of the ramp did not argue for the
reconstruction of the rugged trails, but for the symbolic value of the
ramp as welcoming visitors who “mobilized” in varying ways.
Critics argued that given the trails' inaccessibility, the
ramp's “welcome” was an idle, even disingenuous,
gesture of recognition. A distributive aspect was introduced, however,
when several wheelchair users reached the hut by trail, with
considerable assistance from other hikers, and availed themselves of
the ramp. Despite their achievement, it is difficult to justify
the ramp as a distributive measure, since the companions needed to help
the wheelchair users up the steep trail could surely have helped them
up the small set of steps leading to a hut, as could a high-tech
trail-mastering wheelchair. But requiring such a final effort would
have been a deficient welcome – the hut is supposed to be a place
where hikers can rest and lay down their loads, not a site for further
exertion. The ramp's significance as recognition, as opposed to
redistribution, might thus have been strengthened by the occasional
appearance of wheelchair users.

9.
It may
be tempting to respond to such claims by invoking a state of nature as
a baseline for assessing which disadvantages are natural. The thought
is that if we “subtract away” society's contribution
to disadvantage, which is man-made, then we are left with the
contribution of impairment alone, which is “natural.” But
states of nature are artificial constructs, and the conclusions yielded
by their examination largely depend on the features built into them.
Proponents of a medical model of disability might invoke a Hobbesian
state of nature, wherein people who are missing limbs or senses would
be at a fatal disadvantage in the war of all against all. It should be
apparent that such a state of nature is not merely a fiction, but an
implausible one: any human environment contains pervasive artifice,
technology, some social order, and an implicit or explicit system of
entitlements. There is no obvious reason for relying on a hypothetical
state of affairs lacking these features as a baseline for assessing the
causal role of impairments, or the advantages conferred on people with
impairments in moving to a political state. In contrast, some
disability activists appear to invoke an environment of limitless
resources and technologically-assisted access. Although the reliance on
such an environment as a baseline may seem utopian, it can more
reasonably be seen as a corrective for the tendency to take the present
environment as fixed or past environments as nasty and brutish
(Gliedman and Roth 1980, 13–15; Wasserman 2001). Some philosophers
have attempted to make the distinction between artificial and natural
disadvantages without recourse to a state of nature (see
Lippert-Rasmussen 2004 and Nagel 1997). But in the absence of an
accepted basis for making the distinction, what counts as
“natural” for humanity remains a contentious normative
judgment.

10.
It is interesting to point out that the debate about causation,
responsibility and justice that occurs between proponents of the
medical and social models is in a sense orthogonal to the debate in
which luck egalitarians are engaged. Whereas the former debate centers
on the relationship of individual traits and social arrangements, luck
egalitarians contrast fortune and choice, and generally don't
include society as an actor whose causal responsibility is at issue.
Historically, this difference in emphasis may be due to the fact that
luck egalitarianism arose as a response to Nozickian right-of-center
arguments against Rawlsian egalitarianism (see, Dworkin 1981a) which
emphasized individual choice and property rights.

11.
A second, related, way
in which distributive justice theorists have approached social and
cultural identity is as a commitment that gives rise to inefficiencies
in the conversion of resources into welfare. A culture with elaborate
traditions of celebration and gift giving may be more expensive to
maintain than one emphasizing simplicity and austerity, though no less
central to its participants' well being. But even if a culture is
not inherently expensive, it may be costly to sustain if only a small
number or proportion of the population participates in it (Heath 1998;
Kymlicka 1989). This view of culture is similar to the conventional
view of disability in distributive justice – an unchosen
circumstance that makes it harder to convert resources into welfare.
Though culture may be more voluntary than disability, both are subject
to varying identification – an individual may repudiate or
embrace a culture, or regard a disability as a burden to be alleviated
or an identity to be affirmed. To the extent that either is regarded as
more of a choice than a circumstance – to employ a standard
distinction in distributive justice – it might appear that its
additional costs should not be collectively borne. But to the
extent that those additional costs arise not from anything inherent in
the culture or disability, but from its minority status, there is a
stronger case for collective support – its cost is attributable
to bad demographic luck (Kymlicka 1989). In treating the disadvantages
of people with disabilities as due in significant part to their
position as a statistical minority, this view of disability has
interesting affinities with the human variation model.

12.
Appiah also notes that individual identity may have features that
do not form the basis of a collective identity and for which there is
no corresponding social category. These features may be in a sense
social, but they differ from features like race, religion, or sex in
that there are no societal expectations for how people who share those
features ought to behave. Thus, for example freelance workers are
creating group spaces to work, to give them community despite their
deliberately independent styles of work. But there are at present no
societal expectations governing their behavior. Admittedly, the line
between an individual's personal and the collective dimensions of
individual identity is somewhat fuzzy, but the distinction is helpful
when we move on to consider whether disability status is or should be
an aspect of individual identity.

13.
The sentence in the text reflects a distinction between
“Deaf” as a culture and “deaf” as a lack of
hearing.

14.
Deaf culture necessarily
lacks this enveloping and insular quality in part because of the
epidemiology of deafness: most deaf children are raised by hearing
parents, and vice-versa, and except for occasional concentrations,
(like Martha's Vineyard in the 19th century), deaf people are
geographically dispersed.